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General NPI Number Information
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NPI Number | 1568625358
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Entity Type | Organization
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Legal Business Name | ELIZABETH L. TRAN D.M.D, INC.
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 2657 W EDINGER AVE
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City | SANTA ANA
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State | CA
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Zip | 92704-3521
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Country | US
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Telephone | 714-850-9121
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Fax | 714-850-9217
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Provider Business Mailing Address
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Address Line | 2657 W EDINGER AVE
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City | SANTA ANA
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State | CA
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Zip | 92704-3521
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Country | US
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Telephone | 714-850-9121
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Fax | 714-850-9217
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELIZABETH LISA TRAN
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Credential | D.M.D
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Telephone | 714-850-9121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 49816
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License Number State | CA
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